{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:23:57Z","timestamp":1755224637123,"version":"3.43.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The study analyses perioperative outcomes in patients who underwent transcatheter electrosurgical laceration and stabilization of the clip (ELASTA-clip), followed by transapical mitral valve replacement or conventional mitral valve surgery (MVS) after failed transcatheter edge-to-edge mitral valve repair.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Consecutive patients who experienced failure of a transcatheter edge-to-edge mitral valve repair and subsequently underwent either the ELASTA-clip procedure followed by transapical mitral valve replacement or conventional open MVS were retrospectively analysed. Perioperative and mid-term outcomes including mortality, stroke, bleeding, pacemaker implantation, and the need for mechanical circulatory support were assessed descriptively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 5 patients were enrolled in the ELASTA group and 31 in the open surgery group, with median follow-up periods of 2\u2009years [IQR: 1.2-2.1] and 1.4\u2009years [IQR: 0.3-3.7], respectively. Procedural success was achieved in all ELASTA cases (100%) compared to 96% in the open surgery group. No in-hospital deaths occurred in the ELASTA group, whereas the surgical group had a mortality rate of 6.5% (n\u2009=\u20092). During follow-up, adverse events occurred in 20% (n\u2009=\u20091) of ELASTA patients and 54.8% (n\u2009=\u200917) of those who underwent surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Surgical intervention in patients with failed edge-to-edge mitral valve repair carries a high risk of complications. The ELASTA-clip technique, combined with transapical mitral valve replacement, offers a minimally invasive and safe alternative to conventional surgery, highlighting the need for further prospective studies with longer-term follow-up.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaf183","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T12:12:54Z","timestamp":1753963974000},"source":"Crossref","is-referenced-by-count":0,"title":["Electrosurgical Laceration and Stabilization of Clip Followed by Transapical Mitral Valve Replacement after Failed Transcatheter Edge-to-Edge Mitral Valve Repair: A Promising Alternative to Surgery"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5518-173X","authenticated-orcid":false,"given":"Fabio","family":"Pregaldini","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mevl\u00fct","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8859-8884","authenticated-orcid":false,"given":"Maria","family":"Nucera","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selim","family":"Mosbahi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai Alexander","family":"M\u00fcnker","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Potratz","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5416-165X","authenticated-orcid":false,"given":"Fabien","family":"Praz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Reineke","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3305-9343","authenticated-orcid":false,"given":"Matthias","family":"Siepe","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern , 3010 Bern,","place":["Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7440-6917","authenticated-orcid":false,"given":"Clarence","family":"Pingpoh","sequence":"additional","affiliation":[{"name":"Clinic for Cardiovascular Surgery, Department University Heart Center Freiburg Bad Krozingen, University Clinic Freiburg , 79106 Freiburg,","place":["Germany"]},{"name":"Faculty of Medicine, Albert Ludwigs University Freiburg , 79098 Freiburg,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"2025081218224203800_ivaf183-B1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1136\/heartjnl-2014-307020","article-title":"The modern epidemiology of heart valve disease","volume":"102","author":"Coffey","year":"2016","journal-title":"Heart"},{"key":"2025081218224203800_ivaf183-B2","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1093\/icvts\/ivaa270","article-title":"Mitral valve surgery after a failed MitraClip procedure","volume":"32","author":"Melillo","year":"2021","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2025081218224203800_ivaf183-B3","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1055\/s-0042-1742757","article-title":"Clinical outcomes after mitral valve surgery in failed MitraClip procedures","volume":"71","author":"Pingpoh","year":"2023","journal-title":"Thorac 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